Idelisse Almodovar, DMD
Individual provider Active NPI Dentist · Hatillo, PR
NPI 1245440882 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1245440882
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 2361 (PR)
- Practice address
- Carr 493 Bo Carrizales
Del Norte Medical Center
Hatillo, PR 00659 - Phone
- (787) 878-8854
- Fax
- (787) 881-5511
- NPI assigned
- May 23, 2007
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2361 | PR | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Neurology Consultant Services | Past | Accepting new patients | |
| Jose a. Rodriguez Robles, PSC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 2361 | PR | Yes |
Addresses
Primary practice location
Carr 493 Bo Carrizales
Del Norte Medical Center
Hatillo, PR 00659
Mailing address
PO Box 143777
Arecibo, PR 00614-3777
Phone (787) 878-8854
Other providers in Hatillo, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.